A child with leukemia is receiving methotrexate for therapy. ...

[jrubin]

A child with leukemia is receiving methotrexate for therapy. Which nursing diagnosis should the nurse use to best guide this patient's care at this time?
 
  A) Impaired oral mucous membrane related to effects of chemotherapy
  B) Risk for impaired mobility related to depressant effects of methotrexate
  C) Excess fluid volume related to effect of methotrexate on aldosterone secretion
  D) Risk for self-directed violence related to effect of methotrexate on central nervous system

Question 2

The nurse is helping a 14-year old boy who has asthma to administer medication via an inhaler. Which of the following describes a developmentally appropriate nursing intervention for this child?
 
  A) Involve the adolescent's parents in the administration of the medication.
  B) Allow the adolescent to handle a demo inhaler prior to administering the medication.
  C) Offer the adolescent a special treat if he uses his inhaler correctly.
  D) Treat the adolescent as an adult when explaining the use of the inhaler.

[Jane]

Answer to Question 1

A
Feedback:
Mucositis or ulcers of the gum line and mucous membranes of the mouth is a frequent effect of antimetabolic drugs. This is the diagnosis that would have the highest priority for the patient's care at this time. Methotrexate does not impair mobility, impact aldosterone secretion, or cause adverse effects to the central nervous system.

Answer to Question 2

D
Feedback:
The adolescent is developing a sense of identity and the nurse should foster this by approaching him in the same manner as adults, with respect and sensitivity to his needs. The nurse would involve the parents of children younger than school age in the actual administration of medications and reward the school-age child to enhance cooperation if necessary. Toddlers and preschoolers would benefit from handling and playing with equipment prior to use.

[jrubin]

TYSM

[xthemafja]

Excellent